中文摘要：

目的探讨注射用重组促胰岛素分泌素（recomb inant exend in-4 for in jection,E-4）治疗对2型糖尿病（T2DM）患者血浆成纤维细胞生长因子-21（FGF-21）水平的影响。方法采用酶联免疫法测定40例健康对照和33例T2DM患者血浆FGF-21水平以及使用E-4治疗前后的变化,探讨血浆FGF-21水平与体重指数（BM I）、腰臀比（WHR）、血脂、血糖及胰岛素等的关系。结果 T2DM患者血浆FGF-21水平明显升高〔（2.16±0.20）vs（1.53±0.36）μg/L,P〈0.05〕。多元逐步回归分析表明,HbA1 c及TG是影响血浆FGF-21水平的独立危险因素（YFGF-21=1.370＋0.069XHbA1 c＋0.056XTG）。E-4治疗后T2DM患者血浆FGF-21水平明显低于用药前〔（2.15±0.21）vs（1.99±0.12）μg/L,P〈0.05〕。结论 T2DM患者血浆FGF-21水平改变可能与其代谢紊乱和胰岛素抵抗有关,并可能是E-4作用的生物靶点之一。

英文摘要：

Objective To investigate the effects of recombinant exendin-4（E-4） on plasma fibroblast growth factor-21（FGF-21） levels in patients with type 2 diabetes mellitus（T2DM）.Methods 33 T2DM patients with plasma glucose poorly controlled undergone oral hypoglycemic agents（OHA） therapy were divided into control and test groups.14 patients of control group were administrated with original OHA therapy for 12 w,while 19 patients of test group were administrated with abdominal subcutaneous injection of E-4 together with original OHA also for 12 w.Plasma FGF-21 levels were measured by enzyme-linked immunoassay.The relationship between plasma FGF-21 level and metabolic parameters were also analyzed.Results Fasting plasma FGF-21 level was higher in test group compared with that in control group（（2.16±0.20） vs（1.53±0.36） μg/L,P0.05）.Multiple regression analysis showed that HbA1c and TG were the independent related factors influencing plasma FGF-21 level（YFGF-21 = 1.370＋0.069XHbA1c＋0.056XTG）.Fasting plasma FGF-21 level was decreased significantly in T2DM group after treated with E-4（（2.15±0.21） vs（1.99±0.12） μg/L,P0.05）.Conclusions FGF-21 maybe play a role in the metabolic mechanism of E-4.The change of plasma FGF-21 level may be related to metabolic disturbance and insulin resistance,it might be a biology target of E-4.